Toxicity Self-Test

We live in an environment where we are drenched in toxic elements: water we drink and wash with, lakes and pool we swim in, even the sea and the ocean, food, soil where the food grows, air outside and inside our homes are some of the examples.  Toxic elements affect the most basic functions of our cells and cause severe and chronic conditions.

Take the test below to see if your health is adversely affected by toxic elements in your body.  If your score is over 40 call us for an appointment.  With the help of specific lab tests we can determine the level of toxic elements in your body and recommend a chelation plan, IV and/or oral.

                                                        Toxicity Self-Test

Rate each of the following symptoms based upon your health profile for the

past 30 days.

Point Scale:

  • = Never of almost never, have the symptom
  • = Occasionally have it, effect is not severe
  • = Occasionally have it, effect is severe
  • = Frequently have it, effect is not severe
  • = Frequently have it, effect is severe

DIGESTIVE SYSTEM

______Nausea or vomiting

______Constipation

______Diarrhea

______Belching, passing gas

______Heartburn

______TOTAL

HEAD

——-Headaches

——–Faintness

——–Dizziness

———Insomnia

———TOTAL

EARS

———Itchy ears

———Earaches, ear infections

———-Drainage from ear

——–Ringing in ears

———Hearing loss

———TOTAL

EYES

———-Watery, itchy eyes

———-Swollen, reddened, or sticky eyelids

———-Dark circles under eyes

———–Blurred  or tunnel vision

__________TOTAL

JOINTS

__________Pain or aches in joints

___________Arthritis

___________Stiffness, limited movement

___________Pain, aches in muscles

___________Feeling of weakness or tiredness

__________TOTAL

MOUTH | THROAT

_________Chronic coughing

_________Gagging, frequent need to clear throat

_________Sore throat, hoarse

__________Swollen, or discolored tongue, gums, lips

___________Canker sores

____________TOTAL

MIND

____________Poor memory

____________Confusion

___________Poor concentration

____________Poor coordination

____________Difficulty making decisions

____________Stuttering, stammering

____________Slurred speech

___________  Learning disabilities

___________TOTAL

WEIGHT

___________Binge eating/drinking

___________Craving certain foods

___________Excessive weight

___________Water retention

__________Underweight

__________TOTAL

LUNGS

___________Chest congestion

____________Asthma, bronchitis

____________Shortness of breath

_____________Difficulty breathing

_____________TOTAL

NOSE

___________Stuffy nose

___________Sinus problems

___________Hay fever

___________Sneezing attacks

___________Excessive mucus

___________TOTAL

ENERGY | ACTIVITY

_________Fatigue, sluggishness

_________Apathy, Lethargy

_________Hyperactivity

_________Restlessness

_________TOTAL

SKIN

_________Acne

_________Hives, rashes, dry skin

_________Hair loss

_________Flushing or hot flushes

_________Excessive sweating

__________TOTAL

EMOTIONS

_________Mood swings

__________Anxiety, fear, nervousness

___________Anger, irritability

___________Depression

___________TOTAL

HEART

 ­­­­­­­_____.  Skipped heartbeats

______.   Rapid heartbeats

______.    Chest pain

_______.    TOTAL

 

 

OTHER

_______. Frequent illness

________.  Genital itch, discharge

_________Frequent or urgent need to urinate

_________TOTAL

GRAND TOTAL

If your score is 40 or higher, your health might be adversely affected by toxicity.  Call us for an appointment at 303-942-0159 to learn if it is appropriate to detoxify at this time.